Instead, Ontario has watched the use of repeat nerve injections - and billings for them - balloon. The province has targeted the unbounded growth in nerve block billing in the past but failed to reel it in. ![]() These costs make up 30 to 40 per cent of physicians’ billings, according to the clinics. The billings are not the doctors’ take-home pay and do not take into account the often-hefty overhead costs for physicians’ equipment, staff salaries and rent. The data detail the exact service for which doctors billed the province, as well as the date, the amount reimbursed and a patient ID code, though no patient names. This investigation stems from seven years of data for the 100 top-billing doctors, obtained from the Ministry of Health. “It’s not consistent with any training that I’m aware of.”ĭemian and Konasiewicz, like some other pain doctors named in this story, did not respond to repeated requests for comment from the Star. “That’s not a doctor attempting to heal someone. Jesse Lipnick, a physical medicine specialist and president of the Florida Society of Interventional Pain Physicians. “We have a medical term for what you just described: highway robbery,” said Dr. To put that in perspective, the government of British Columbia says all of its doctors combined did only 55,595 nerve block and epidural procedures that same year. Stefan Konasiewicz, billed for doing nearly 40,000 procedures, with a cost to the province of more than $2.2 million. In fiscal year 2017/18 alone, Demian billed the province for doing more than 38,300 nerve block procedures, totalling close to 69,000 injections. Ontario doctors bill for nerve blocks like nowhere else. ![]() The tax-funded health system has paid more than $420 million for these kinds of nerve blocks since 2011. The skyrocketing use of nerve blocks has swollen the public’s tab for chronic pain management despite a paucity of evidence to show regular, repeat injections are an effective way to treat chronic pain. Over roughly three years, Demian gave the single patient 1,999 nerve blocks, all billed to the public purse.ĭemian’s heavy use of nerve blocks account for nearly $8.4 million of the $13.3 million he’s billed the Ontario Health Insurance Plan since 2014, catapulting him near the top of Ontario’s top-billing doctors.Ĭlick here to search the Star’s database of Ontario’s top-billing doctorsĪ Star investigation has found top-billing pain doctors capitalize on Ontario’s lax limits on nerve blocks, giving patients weekly injections despite medical guidelines saying the procedure should be done no more than once every three months. This patient, who was being treated for chronic pain, visited Demian about every four days for as many as eight nerve blocks - far more than guidelines recommend. That July 2017 appointment was much like the hundreds that came before it. Then he did it again, a pair of nerve blocks into the patient’s legs.īy the time he was done, Demian had performed eight injections. Hany Demian inserted a needle into the pelvis and injected a local anesthetic to numb a nerve and stifle the pain that travels through it. Since joining the Cancer Center of Kansas in 1999, he has greatly contributed to the mission of the center, providing the highest quality patient care with the latest advances in clinical cancer research.With the patient before him, Dr. Francis and in 2021 was renamed to Cellular Therapy Center of Kansas. Mattar became the Director of the Blood and Marrow Transplant Program, which is an integrated program of the Cancer Center of Kansas, America Red Cross and Ascension Via Christi Hospital St. He is a Clinical Assistant Professor of Internal Medicine at the University of Kansas School of Medicine. Mattar continues to be active in clinical cancer research as a Principal Investigator in our Wichita NCI Community Oncology Research Program, a National Cancer Institute sponsored program, and other areas of clinical research with interest and expertise in allogeneic bone marrow transplantation. He is a member of the American College of Physicians, the American Society of Clinical Oncology, the American Society of Hematology, the Southwest Oncology Group and the American Society for Blood and Marrow Transplantation. He is board certified in Internal Medicine, Medical Oncology and Hematology. Following the completion of his fellowship in 1999, he joined the Cancer Center of Kansas team. ![]() Mattar also completed a fellowship in Oncology/Hematology and Bone Marrow Transplantation at the University of Alabama, Birmingham, Alabama, in 1999. He completed his internal medicine residency at the University of Kansas School of Medicine – Wichita, Kansas. Joseph University School of Medicine, Beirut, Lebanon in 1993. Mattar received his medical degree from St.
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